Diabeties and obesity Flashcards
What are the different types pf GLUT transporters and what do they do
GLUT 3 not insulin dependant on neuronal cells
GLUT 4 insulin dependant muscle and fat cells
How is blood glucose raised at rest.
The liver converts glycogen to glucose
What is diabeties
A group of disorders categorised by a persistently raised blood glucose
A lack of insulin
Inability to respond to insulin
What is diabetes insipidus
This has no relation to blood glucose and is instead related to the hormone ADH leading to excessive urination and thirst
What causes type 1 diabetes
This is insulin deficient due to 90% destruction in islets of langerhans cells
Rapid onset:
Polyuria
Polydipsia
Weight loss
Fatigue
How and how often is blood glucose measured
HbA1C should be measured every 3 months
What is DKA
Diabetic ketoacidosis
Glucose finger prick may be 30+ or reading HI
Symptoms: confusion
Nausea abdominal pain
Gasping and air hunger
Sweet smell to breath
This is a medical emergency and causes an increases in circulating ketones and therefore blood pH becomes more acidic
This is more likely with dental infection, surgery, missed insulin and binge drinking
What is HHS
Hypersmolar hypoglycaemic state
This has the same symptoms as DKA but is extremely difficult to treat
What is type two diabetes
This is where fat and muscle cells are unresponsive to insulin and don’t take up the glucose in the blood stream and there is suppressed ability for the live to reduce glucose after eating hence why it remains high sometimes in diabetic patients
What are the risk factors for T2DM
Poor diet
Obesity
Family history
Ethnicity
History of gestational diabetes
Medications
What is gestational diabetes
This is where diabetes occurs in pregnancy
Insulin resistance
Associated with stillbirth
Pre-eclampsia
This increases the risk of actual T2DM development
What are chronic conditions that arise as a result of T2DM
Microvascular disease - capillary endothelial damage and neuropathy
Macrovascular disease - accelerated atherosclerosis
Metabolic complications
Wound healing complications (neutrophils abnormalities)
Secondary infection due to favoured conditions
How does T2DM affect the mouth
Periodontal disease due to altered immune function salivary gland function and increased periodontal destruction.
Xerastomia - dehydration due to diabetes decreases salivary flow and altered quality
Sialosis asymptomatic and non inflammatory enlargement of the major salivary glands
Fungal infections - mostly candidiosis (this is mostly treatable but can sometimes be severe eg mucomycosis or aspergillosis).
Adverse taste
How is diabetes managed
Insulin (humalog (short acting) and lanctus (long acting)
Oral hypoglycaemic agents
Metformin need some insulin to be present
Sitagliptin indirectly increases insulin production
Gliclazide can induce a hypo if taken without food
What is obesity defined by
BMI over 30
